Effects Of Repetitive Transcranial Magnetic Stimulation On Lower Extremity Motor Function In Patients After Stroke

Objective: Lower extremity motor dysfunction is one of the sequelae of stroke which affects the walking function and activities of daily living of patients.Many studies have shown that repeated transcranial magnetic stimulation had a certain effect on the complications left after stroke.This study was designed to investigate the effects of repetitive transcranial magnetic stimulation at different frequencies on the recovery of lower extremity motor function in patients with hemiplegia after stroke.Method: Forty-five patients with hemiplegia who were eligible and completed the study were randomly divided into a low frequency rTMS group(LF-rTMS),a high frequency rTMS group(HF-rTMS),and a sham rTMS group(S-rTMS).All three groups were treated with conventional medication and rehabilitation training,conventional rehabilitation training mainly includes: active and passive activities of lower limbs,standing balance training,sitting balance training,center of gravity transfer training,walking training,trunk muscle training,up and down steps training and activities of daily living activities(ADL)training,etc.The training period was 5 days a week(Monday to Friday)for 3 weeks,30 minutes per day.On this basis,the low-frequency rTMS group was received 1 Hz rTMS stimulation in the primary motor cortex(M1 region)of the non-affected side;the high-frequency rTMS group was received 10 Hz rTMS stimulation in the M1 region of the affected brain;the sham stimulation group received the sham stimulation of the corresponding site.The training period was 5 days a week for 3 weeks,20 minutes per day.Before receiving rTMS or sham stimulation treatment and after 3 weeks of treatment,Fugl-Meyer motor assessment scale of Lower Extremity(FMA-LE),Functional Ambulation Classification(FAC),10 meter maximum walking speed(10 mMWS),Timed “up and go” test(TUGT)were used to evaluate the motor function of lower limbs of the three groups;The neurophysiological parameters were evaluated by central motor conduction time(CMCT)and Motor evoked potential(MEP)cortical latency.Finally,STATA 12 statistical software was used to statistically analyze the data obtained from each group.(((?)±S)) was used to represent the measurement data,the paired sample t test was used to compare the differences between the same group before and after treatment,the difference analysis between the three groups was performed by one-way ANOVA.P<0.05 indicates that the difference is statistically significant.Result: There was no significant difference in the general data of age,sex,height,duration of disease and stroke type of the three groups before treatment(P>0.05).Before treatment,there were no significant differences in FMA-LE,FAC,10 mMWS,TUGT,MEP cortical latency and CMCT between the 3 groups(P>0.05).After 3 weeks,the FMA-LE,FAC,10 mMWS,TUGT,MEP cortical latency and CMCT were improved compared with those before treatment(P<0.05).The low-frequency rTMS group and the high-frequency rTMS group compared with the sham rTMS group,the above indicators improved more obviously,and had significant significance(P<0.05);There was no significant difference between the low-frequency rTMS group and the high-frequency rTMS group.Conclusion: Both low-frequency and high-frequency rTMS can promote the recovery of lower limb motor function,increase walking speed,improve walking function and daily living ability in patients with hemiplegia after stroke,and there was no significant difference between them.